Graber S, Hess R, Noesberger B
Orthopädisch-traumatologische Abteilung, Regionalspital, Interlaken.
Helv Chir Acta. 1994 Apr;60(4):643-6.
Between 1980 and 1989, 210 patients with 212 femoral shaft fractures were treated at our hospital, 191 patients with 193 fractures (91%) had a follow-up control. Of these 193 fractures only 16 required totally 26 (13.5%) reosteosynthesis, with AO-Switzerland performing 625 (14.5%) reosteosynthesis in the same period of time, with the methods of primary fracture care only varying inconsiderably. The different reasons for reinterventions were planned reosteosynthesis, malposition, delayed union and pseudoarthrosis, loose and broken implants and infection. In comparison with AO-Switzerland the main difference was that we had no case with malposition (AO-Switz. 20%) leading to reosteosynthesis. The early infection rate at our hospital was 0.9% (AO-Switz. 2.6%) in comparison to a late infection rate of 2.1% (AO 2.2%). The screw-plate osteosynthesis and reamed femur-nail have both proved to be safe methods for primary fracture care, whereas combined osteosynthesis (e.g. two plates/reamed femur-nail and a plate) has a high rate of reosteosynthesis and therefore should be avoided.
1980年至1989年间，我院共治疗210例股骨干骨折患者，计212处骨折，其中191例患者的193处骨折（91%）获得随访。在这193处骨折中，仅16处（占总数的13.5%）共进行了26次再次骨固定手术，同期瑞士AO组织进行了625次（占总数的14.5%）再次骨固定手术，一期骨折治疗方法的差异微不足道。再次手术的不同原因包括计划再次骨固定、骨折移位、骨愈合延迟和假关节形成、植入物松动和断裂以及感染。与瑞士AO组织相比，主要差异在于我们没有因骨折移位（瑞士AO组织为20%）而导致再次骨固定的病例。我院早期感染率为0.9%（瑞士AO组织为2.6%），晚期感染率为2.1%（AO组织为2.2%）。钢板螺钉内固定和扩髓股骨钉均被证明是一期骨折治疗的安全方法，而联合内固定（如双钢板/扩髓股骨钉加钢板）再次骨固定率较高，因此应避免使用。
